Fecal Incontinence

Fecal incontinence can be defined as the inability to hold a bowel movement until reaching a bathroom.

It may be associated with:

Sudden strong urgency

Lack of the sensation of needing to have a bowel movement

Having trouble holding a bowel movement, with solid or liquid stool leakage

Finding streaks of stool in your underwear

Having to avoid specific foods

Having to arrange your day around being close to a bathroom

Causes

Diarrhea, constipation, damage to pelvic muscles or nerves, aging, childbirth, physical injury, diseases or conditions such as IBS or Crohn’s disease, or weakened pelvic floor muscles. It affects people of all ages, and is most common in women and in older adults. The key to successful bowel control treatment depends on correctly diagnosing the underlying problem.

Treatments

May include management options such as absorbent products, lifestyle changes such as diet modifications, behavioral treatment options such as bowel retraining, pelvic muscle exercises and biofeedback, or medications. Surgical options such as sacral nerve stimulation (InterStim therapy) or various other surgeries are often successful.

Pelvic floor muscle dysfunction is a common contributor to bowel control issues and can lead to:

Decreased ability to contract and hold the muscles that prevent stool leakage, and/or to relax these muscles as appropriate to empty the bowels.

Impaired ability to sense stool in the rectum, or to notice it “too late”

Rectal prolapse with sagging and stretching of muscles and nerves

Biofeedback is often used to work on these issues. It is a simple, painless teaching technique which provides on-the-spot information (or feedback) about your pelvic floor muscle control, strength, endurance and ability to relax the muscles. Small biofeedback sensors are inserted into the anus (opening of the rectum) or vagina and connected to a computer. Signals from your muscles tightening and relaxing are displayed in a graph format for you to see, and are interpreted and explained to you by your biofeedback specialist. This, combined with daily home exercises (Kegel’s), bowel retraining techniques, urge suppression techniques, and diet/fiber/fluid modification often leads to significant improvement in bowel control.

Severe fecal incontinence may require more advanced treatment and collaboration with additional physicians in the fields of gastroenterology or colorectal surgery. Your physician will work with you to decide on the most appropriate and effective treatment options to help control your symptoms and improve your quality of life.